A team of Oxford University researchers has developed a technique that could improve heart scans for patients, giving more information about the heart than traditional scans and without any injections, making them safer and faster.
The group of medical, physics and engineering researchers are based at the Oxford Centre for Clinical Magnetic Resonance Research (OCMR). They are using a property of hydrogen atoms to create a pixel-by-pixel map of the heart, called a T1-map, which allows examination of healthy and diseased heart tissue in greater detail than before.
Currently, stress scans of the heart using magnetic resonance imaging (MRI) require patients to be injected with two substances. Adenosine is a medication injected into the patient that causes effects similar to exercise during the scan. Gadolinium - a rare earth heavy metal - is injected as a contrast agent to highlight areas of the heart suffering from decreased blood flow under exercise conditions.
Dr. Alexander Liu, who leads the research with the guidance of his supervisors – Dr. Vanessa Ferreira, Dr. Stefan Piechnik and Professor Neubauer (the centre director), explained: 'We wanted to see if using T1 mapping can give clearer, more clinically-useful results compared to traditional MRI scans that require injections of contrast agents. On traditional MRI scans, doctors are judging relative shades of light and dark on a scan, and even the most experienced specialists can disagree on what the image is showing them. T1 maps provide an objective number, which can be coded in colours, and may be less subjective. Additionally, patients with severe kidney failure – who are usually at higher risk for heart disease – cannot clear Gadolinium and often are unable to benefit from a full MRI scan of the heart. T1-maps can potentially solve this problem in the future.'
In physics, T1 is the time constant that describes how quickly atoms return to normal thermodynamic state after being affected by radio waves and strong magnetic fields. Just like measuring body temperature in Celsius or Fahrenheit, the numbers themselves may not mean much, but any deviation from established normal ranges can suggest disease. In the case of T1 mapping, long T1 times indicate the presence of more water, something found in a number of heart conditions, including areas of the heart suffering from lack of blood supply due to blocked arteries. A T1-map just helps to visualize T1 values across the heart and find the precise location of the problem. It takes around three minutes to map the whole heart, and the values it measures are turned into a colour map, giving doctors an image which is potentially quicker to understand with less subjective interpretation.
Dr. Stefan Piechnik developed the specific T1 mapping technique at Oxford, named ShMOLLI. He said: 'T1 mapping allows us to look in finer detail at the heart in a non-invasive way, which has not been possible before. We can now get results without Gadolinium, meaning we have a technique that is safer and quicker and can be used with more people. The results are also less dependent on interpreting the images – medics have something based on hard numbers.'
Dr. Liu added: 'Further studies will concentrate on how we can use T1 mapping not only to improve our research but eventually develop this into a tested, clinically proven technique for use with patients worldwide.'
Dr. Vanessa Ferreira, Deputy Clinical Director of the OCMR, said: 'The potential of this research is huge – not only for heart scans. Each type of tissue across the body has a range of normal T1 values, so any values outside that range may signify disease. The pixel by pixel level of detail from these scans could help identify unhealthy tissue wherever it appears. Oxford is now applying this technique to scan other organs. The UK Biobank also aims to scan 100,000 individuals from the UK population using the ShMOLLI T1-mapping technique, which will provide a lot of information on T1 values in health and in certain medical conditions. All these studies aim to translate this technique into clinical use, likely within the next 5 years.'

Neuroticism, a personality trait related to depression, anxiety and even heart disease, can be linked to nine new distinct gene-associations according to international research led by the University of Glasgow.
The study, which is published today in Molecular Psychiatry, was co-led by Professor Daniel Smith from the Institute of Health and Wellbeing and included researchers from the Universities of Edinburgh, Cardiff and Queensland, Australia.
The existence of these genetic associations could indicate a person’s predisposition to the personality trait neuroticism.
The authors focused on neuroticism as it is the personality trait most closely associated with mental illness and physical health problems.
People who have high neuroticism levels tend toward depression and anxiety. They also tend to have worse physical health, with links to conditions such as obesity and heart disease.
The research represents the largest genetic study of a personality trait ever undertaken, and improves our understanding of people’s personality differences, and why some are more predisposed to mental health problems than others.
The study tested more than 100,000 individuals from the UK Biobank cohort, the Generation Scotland sample and the Queensland Institute of Medical Research sample.
Professor Smith said: “As a psychiatrist, this is an exciting discovery because we have identified for the first time genetic risk factors for a personality trait which is of fundamental importance for psychological wellbeing.
“This work could open new avenues for future research and for the identification of new treatment approaches for depression and anxiety. It is a first step to understanding the biology and genetic basis of a person’s vulnerability to depression and anxiety.”
Although further work is needed to pinpoint the exact DNA changes responsible, the findings potentially indicate the involvement of molecules linking neuroticism with mental illness.
One has an important role in managing the body's response to stress, while another influences the function of glutamate – an important brain chemical involved in a range of psychiatric disorders, including schizophrenia, depression and suicide.
Professor Ian Deary, from the University of Edinburgh, said, "I have been researching on human personality for almost 30 years. These new results are, at last, a start for our understanding the biological mechanisms that predispose some people to generally feel more anxious and low in mood than others."
Professor Michael O’Donovan, from Cardiff University said “this research confirms at a molecular level what epidemiological research has clearly shown to those who are not blinded by prejudice; to understand the origins of psychological traits, the most human of all our characteristics, we have to understand both our genetic inheritance and our environment.”
Dr Raliza Stoyanova, Neuroscience & Mental Health Senior Portfolio Developer at the Wellcome Trust, said: “By combining a number of very large studies, including UK Biobank, the researchers have identified new genetic associations for neuroticism - one of the five fundamental personality traits present in all of us.
“It will be important for future work to uncover how these genetic links affect brain function, and to pin down whether they increase someone’s chance of developing clinical depression.”
The study is published today in the journal Molecular Psychiatry.

What does the Precision Medicine Initiative need with one million volunteers?
The mission is to create the knowledge, policies, infrastructure and culture to enable more targeted therapies and prevention to keep people healthy. This is the biggest ever longitudinal cohort research programme in the United States. It will create an astonishingly rich array of data that can be used to address issues in health and disease that have dogged us forever, especially in the area of health disparities.
What have you learned from the huge cohort programmes in recent years, such as the Million Veteran Program and the UK Biobank?
You need to start with a small, coherent data set that is defined ahead of time. You don't want to collect everything that everybody might find valuable. Over time, the data set can expand as the infrastructure becomes available.
All the components of the programme must work together. The criteria for picking our partners are not just about how excellent they are, but about how well they will work with the rest of the team. That has not been the case in some previous efforts.
We've also ensured that data are rapidly and widely available. We are creating an awesome data set and need an infrastructure that incentivizes research uses of those data. That has to be in our minds as we build it. And data sharing isn't just between researchers, but also with participants. That makes the PMI unique.
Will participants play an active part in the PMI?
We are co-designing this programme with prospective participants. We have folk on the working group who are participant representatives, and we've included them in all of the levels of governance.
Participants will also decide who can access their information. If someone wants to share his or her data with their health-care provider, or wants us to do that, we will set it up. Access to information will not be mediated by health-care providers, as has been normal practice.
Recruiting volunteers for clinical studies is difficult. How do you plan to do it?
There are two ways that volunteers can come to the cohort programme. One is through health-care providers. These partners will make information about the programme available to the people they serve, and they will be responsible for doing the initial health exam and collecting the biological specimens. That approach is familiar for the NIH.
When President Obama announced the PMI he said he wanted it to be widely available. That's why we created the direct volunteer concept, so anybody, anywhere can raise their hand to participate. We want to make sure we include everybody, not just the tech-savvy, fitness-conscious middle-aged or young folk.
What new issues does that raise for trials?
How do you engage people? How do you collect their information? How do you stay in contact with them? How do we make information about the programme available to people who don't have Internet access? And how do we get to people on the lower end of the socio-economic ladder, who are underrepresented in biomedical research and are generally in poorer health? We haven't ever undertaken citizen science at this scale before, so it is a challenge to design the system so it is open, inviting and rewarding for everybody.
Are you also grappling with questions raised by incorporating data gathered by patients?
Yes. The new PMI Participant Technologies Center will make sense of data from wearables, sensors and detectors. The device I'm wearing on my wrist tells me how many steps I take per day, but actually the raw data it generates could give us a lot more insight. Integrating these kinds of data and new technologies is an exciting part of the cohort programme.
How will you maintain trust between all players, especially the volunteers?
We need to make sure that our decisions about what data to collect, how to protect it, how to share it, and what we will learn from it are all informed by participant voices. We have to be super-transparent, so any participant, prospective participant or member of the public can know what we're doing. We also need to be sure that the science we do will enrich our relationship with participants and not erode it.
And we need to keep our promises. That means honouring our commitments to involve participants at all stages and to do everything we can to protect the privacy and security of the information we collect. There are no perfect systems, and we live in a dangerous world, but we'll do everything we can to protect the privacy of the people we are working with.
What do you worry about late at night?
Privacy and security issues! I also worry about the pace, as we are doing this at an unprecedented speed. We need to make sure we move fast, but that we do things right.

Rsearchers have presented a new study that supports the cardiovascular safety of calcium and vitamin D supplementation. The study was based on analysis of the UK Biobank, a very large study comprising 502,664 men and women aged 40-69 years.